Fighting the Pestilence: Lessons from South Korea

PART III: India, Korea and the Kerala Model: Unequal Comparison?

By Gouranga Gopal Das

Indian economy is on a tailspin with problems of unplanned lockdown on labour-market and welfare, lives vs livelihoods trade-offs, health and food crisis, and both demand and supply-side shocks causing more domino effects. But the ‘Kerala model’ – despite wishful thinking about political overtones—is a success thanks to literacy-induced awareness and consciousness, as well as well-designed public healthcare system, which starkly contrasts with that of the rest of Indian.

An extraordinary effort at the state level translated into a success story, and on the other hand, there is a huge rise in inequality, in general, all over India. In Kerala, the mortality rate is less than one percent and the recovery rate is about 60 percent. Recently a study by Chathukulam (2020) has extensively discussed the factors responsible for Kerala’s case. Without reproducing that finding, it can be attested that a cocktail of factors, like education-related awareness, decentralized institutions, healthcare provisions, safety nets, and ‘public action’ was instrumental behind the ‘small’ state’s ‘big’ image in the global arena. Needless to say, it reiterates the message that Sen (1998) has emphasized in the context of East Asia, comparing it to Kerala as an outlier state.

The previous parts of this piece have shown that in S Korea even with short-span temporary closures a targeted response via policy intervention could reduce the economic impact and health hazards in a quick fashion (Shin et al. August 2020). The recent IMF World Economic Outlook (October 2020) paints a gloomy picture where GDP growth (at constant prices) would be -10.3 percent for India, as well as for Pakistan (-0.4%), Indonesia (-1.5%), Sri Lanka (-4.6%), Afghanistan (-5.0%), Malaysia (-6.0%), while for Bangladesh, Vietnam, China and Nepal it would be 3.8 percent, 1.6 percent, 1.9 percent, and 0.0 percent respectively.

According to Worldometer (October 18), per million COVID-19 deaths is highest in India (83) compared to 34 in Bangladesh, 0.6 in Sri Lanka, 25 in Nepal, 6 in Malaysia, 0.8 in Thailand, 0.4 in Vietnam, and 3 in China. As mentioned by Basu (August 28, 2020), despite having a multifarious advantage in terms of ICT, outsourcing, health and pharmaceutical research, higher education, and young age population, India’s ‘poor handling’ and mismanagement and unfocused policy could ‘derail’ it unless India unlocks its potentials.¹ For example, Banerjee et al (2020) using RCT (Randomised Control Trial) in development economics literature has shown in the context of West Bengal the efficacy of pin-pointed intervention via large-scale messaging system (25 million persons received SMSs) to nudge individuals’ behaviour to practice better precautionary measures related to COVID-19 control. According to their study (NBER July 2020): ‘All messages encouraged reporting symptoms to the local public health worker. In addition, each message emphasized one health-preserving behaviour (distancing or hygiene) and one motivation for action (effects on everyone or just on self). Some messages addressed concerns about the ostracism of the infected. As control, three million individuals received a message pointing them to government information. The campaign (i) doubled the reporting of health symptoms to the community health workers (p = 0.001 for fever, p = 0.024 for respiratory symptoms); (ii) decreased travel beyond own village in two days by 20 percent (p = 0.026) (on a basis of 37% in control) and increased estimated hand-washing when returning home by 7 percent (p = 0.044) (67.5% in control); (iii) spilled over to behaviours not mentioned in the message, such as mask-wearing was never mentioned but increased 2 percent (p = 0.042), while distancing and hygiene both increased in the sample where they were not mentioned by similar amounts as where they were mentioned; (iv) spilled over onto nonrecipients within the same community, with effects similar to those for individuals who received the messages.’ This shows that it is possible to control the spread of infection and trace the infection rates with proper implementation and targeted policy response as South Korea has done by adopting proper measures.

In the case of Kerala, the ingredients for success was past achievements in terms of universal healthcare, education, People’s Plan Campaign with deep public engagement, ‘rapid response team’ focusing on coordination-communication-community engagement (3Cs) to promote 3W’s (Washing hands, Wearing masks, Watching social distancing), and taking advantage of online counselling via WhatsApp groups, call centres, GIS maps to locate camps for migrant workers and vulnerable social groups without any divisiveness, but practising ‘inclusiveness’. This created, as in the case of S Korea, an ecosystem of trust, faith, belief, along with pin-pointed targeted policy intervention, and hence, promoting participatory governance in a transparent manner.

This type of intervention unlocks new doors, facilitates wide-spread applications, and makes a sustained positive impact for the underprivileged. With the lead of S Korea (as part of Comprehensive Economic Partnership Agreement and Regional Comprehensive Economic Partnership), India could further strengthen its healthcare, technology transfer, digital infrastructure, e-commerce, and research alliance so that via ‘Act East Policy’ and open and inclusive Asian regionalism, India too can reap long-term benefits and overcome this short-term dismal situations. Post COVID-19 era could usher in new dimensions and a global alliance is necessary to get over the deep recession. In this context, I would mention S Korea’s Deputy Prime minister and Minister of Economy and Finance Mr Hong Nam-Ki’s call for ‘action plan’ by national leaders and role of G20 leadership– based on solidarity, cooperation, and mutual trust to solve the pandemic-induced recession and health shocks.²

Lessons and Reflections

On the whole, the previous discussions of tackling the pandemic in S Korea vis-à-vis other comparator nations reveal important insights for different economic and political systems across countries. The lessons are quite varied. S Korea, as discussed earlier, has had a proud history of revival from colonial oppression and war ravages in a very short period of time. Civil society has carved out a constructive role for democratically elected leaders as was seen in 2017 when there were problems of openness, transparency, ferry-disaster, and corruption. This tradition of constructive response and tolerant attitude was instrumental for the successful policymaking to counter COVID-19 with public support for the ‘personal information collection’ as well as social distancing without lockdown.

Often, the spirit of King Sejong’s—the most revered of the kings in the Joseon dynasty— saying in 1425 that ‘I am neither virtuous, nor skilful at governing. There will definitely be times when I do not act upon the heaven’s wishes. So, look hard for my flaws and make me answer to their reprimands.’ – is still not forgotten wisdom. And it pays off.

Lockdown (partial or full) strategy could work for some, and temporarily, as it could entail huge economic burdens in terms of loss of income opportunities which could aggravate health outcomes due to lack of access to medical facilities. On the other hand, without relying on full lockdowns, coordinated efforts with obsequiousness for voluntary social distancing and public confidence is more effective. In the absence of proper healthcare and public/community health facilities, lockdowns might work temporarily but need to be designed with proper planning and monitoring so as to avoid economic loss via further closure of activities.

Combating such virulent virus needs a concerted effort of teams of experts from different fields, such as medical science, pure science, as well as from social science. Combining approaches could open horizons for analysing the effectiveness of specific policies for improving development outcomes in health management, detection, and governance. This requires a concerted effort – cross-fertilization of ideas among scientists and researchers at the macro level – for combating COVID-19 (Das 2020a).

As Benjamin Franklin said: ‘By failing to prepare, you are preparing to fail.’ Preparedness for the reconstruction of a pre-COVID, post-GFC scenario is necessary. Preparing the ground during lockdown to achieve low fatality via command and control is effective only if this disease control results in a resurgence of economic activities with cluster control, testing, surveillance system using Artificial Intelligence and drones to process granular geo-coded data for spatial infection tracking.

S Korea’s case, like a few others, is an outstanding example (Seegene 2020, UN News 2020). For India, Kerala at the state level showed the efficacy of planning and management comparable to some extent with Korea’s efforts. However, what is achieved at the state level might not be replicated at the country level for a big country like India. Establishing a norm for accountability, governance, and trustworthiness is important for countering the devastative impact of COVID-19.   Death rate or case fertility rate can be lowered via a ‘battery of strategies’ combining public health, sound macroeconomic preconditions, quality institutions, medical facilities, as well as economic policies targeted to cure the malaise of dual burdens of supply and demand shocks. As Lee, Heo and Seo (2020) pinpoint, ‘The South Korean approach to COVID-19 may be difficult to emulate even for countries like the US and the UK (Majeed et al., 2020), but provides important policy implications for developing countries and needs for strengthening three core competencies: digital technology, efficient health governance, and civic partnership. Digital technology in developing countries will be critical in responding to future crises including pandemics. When establishing the legal basis for contact tracing, the developing countries should prepare adequate measures safeguarding the privacy of infected individuals. The developing country should reorganize its epidemic response governance and maintain decent quarantine and hygiene practices. In particular, health authorities should consider the reorganization of hospitals by the types and severity of diseases to prevent the spread of the virus within the hospitals. And finally, the developing country should strive for cooperation and capacity building in civic organizations. It is a great challenge for developing countries to fight alone against COVID-19. As such, the international community should work to strengthen these accordingly.’

Cutback on consumption and work due to lockdown reduce the severity of the pandemic (measured by fatality or death rates). However, the higher the uncertainty about lockdown plans, the lower is economic recovery, and the deeper is the recession.  Governments should balance the need to protect lives from COVID-19 and the need to protect livelihoods.

With improper healthcare, inadequate infrastructure, dilapidated medical facilities, lack of trained professionals, scarcity of health facilities, a sudden spurt in death due to COVID-19 will run havoc among the citizens. Public health and institutions are important for readiness. In addition, the containment of the virus is dependent on readiness. The government should give due emphasis on creating supportive health-care plans and infrastructure. The government needs to strike a balance between the trade-offs between collateral damage of lockdown, containment, and the economic fallout without socio-economic disasters. When the share of the informal sector is so high and most of the people are migrating from rural to urban for daily wages, or even long-term livelihood, the impact of mitigation efforts is highly debatable. Climate policies, labour-intensive green infrastructure projects, planting trees, reduced labour taxation, wealth tax for reducing inequality, large-scale green infra projects, green R&D investment are part of a bigger agenda of combating COVID-19.

However, the decision to lockdown with no prior plans is ill-conceived, jeopardizing the lives of the downtrodden. It breaks ‘social contract’ through social distancing for arresting the spread of infection. In other words, abolishing ‘social contact’ at the expense of ‘social contract’—necessary for a modern economy to sustain—could have an adverse impact (Das 2020b&c). Stimulus packages will work in the short run because this crisis will disrupt the supply side also due to implosion in the world economy. Hence, measures chalked out above are necessary, as a supply-side shock cannot be fully handled via a demand-management policy in the end. We need a mix of policies.  We need policies that will address the lives versus livelihood trade-off – the ‘twin crisis’ – health as well as pandemic-led economic repression, by solving the problems of building human capital, social safety net, health and climate policy in tandem. However, a fiscal and monetary policy combined package is necessary for long-run growth objectives. In order to make it a success, it needs cooperation from both sides – the citizens and those in charge of ensuring their better protection via healthcare infrastructure development. This will help in minimising the economic losses incurred during lockdown by supporting the underprivileged, wage earners, and the poor who have a hand-to-mouth existence. The government should use this time-period to boost economic support for the vulnerable, initiate a new form of Private-Public-Partnerships for provision of safety protocol, healthcare facilities, equipment. It needs to stimulate the economy with proper support via flexibility in policymaking by balancing epidemiological and economic trade-off (Das 2020b & 2020c). These kind of preparations and appropriate government interventions are absolutely necessary to prevent transmission as the future is uncertain in terms of seasonal spread or suppression in the absence of the vaccine (Merow and Urban 2020).

As the weaknesses of the development model are exposed, we observe failures on many fronts, like public health in North as well as in Global South, infrastructure, job growth, etc. even before COVID-19. In terms of the social science discipline, there must be a new paradigm shift in the public health and development literature where a new dimension of global challenges emerge. Education lays the foundation for the success of digital architecture. Given that the post-COVID scenario has sent the rural poor into deep uncertainty and education and learning in the urban setting has experienced jolts, compared to the pre-COVID scenario, how can the benefits of digitization be expanded? Will the fiscal stimulus be able to solve the problem? Is it a management problem? How will this financing, like, say, issuing public health bonds cope with that? Human capital is dependent on health and education. Will the huge fiscal stimulus or monetary policy action have that approach to address this dual role because it is a twin crisis needing three-pronged approach – social, economic, and governance?

Rethinking economics with transdisciplinary focus is a new necessity (Das 2020a). As has been mentioned by the World Bank (2020) that for mitigating the unprecedented crisis led by the ‘global health emergency’ the policy responses ‘must be carefully calibrated’ to address the three-pronged priorities, namely, (i) disease containment and access to healthcare, creating awareness program for better health and sanitation practices, (ii) protecting income or guaranteeing income support, saving jobs, and (iii) macroeconomic policy for stability, trust-building, and better ecosystem via social protection. However, given the severity of impacts on health and wealth trade-off, policy flexibility is important for boosting the morale of citizens and making the shutdown of productive activities more effective. In other words, for building trust and hope among despair a clear policy of containment of the disease should be transmitted to the people and at the same time, we need to make sure that utmost compliance with the norms of careful social or physical distancing is practised.

AUTHOR
Gouranga Gopal Das, Professor of Economics, Hanyang University, Seoul and Erica Campus, South Korea

This is Part III of a three-part piece.
Part I: A Multidimensional Crisis
Part II: COVID in South Korea

REFERENCES

Asian Development Bank (June 2020). Kijin Kim, Sunae Kim, and Cyn-Young Park. ADB Briefs. Food Security in Asia and the Pacific amid the COVID-19 Pandemic. Pp. 1—15.

Atkeson Andrew, Karen Kopecky, and Tao Zha (August 2020). Four Stylized Facts about COVID-19. National Bureau of Economic Research. Working paper 27719. Pp. 1-44.

Aum, S., S. Y. Lee, and Y. Shin (April 2020). Inequality of Fear and Self-Quarantine:

Is There a Trade-off between GDP and Public Health? Pp. 1-31. Paper presented at the Annual Korean Economic Association Conference 2020 in Seoul.

Caggiano, Giovanni., E Castelnuovo, and R. Kima (2020). The global effects of COVID-19-induced uncertainty. Economics Letters. Pp. 1-5, Vol. 194.

Banerjee, Abhijit., Marcella Alsan, Emily Breza, Arun G. Chandrasekhar, Abhijit Chowdhury, Esther Duflo, Paul Goldsmith-Pinkham, and Benjamin A. Olken (July 2020). Messages on COVID-19 Prevention in India Increased Symptoms Reporting and Adherence to Preventive Behaviors Among 25 Million Recipients with Similar Effects on Non-recipient Members of Their Communities. NBER Working paper 27496. NBER, Chicago, https://www.nber.org/papers/w27496.pdf

Belot, M., S. Choi, J. C. Jamison, N Papageorge, E. Tripodi, and Eline Vanden Broek-Altenburg (May 8, 2020). Six-Country Survey on COVID-19. Paper presented at the Annual Korean Economic Association Conference 2020 in Seoul. Pp. 1-43.

Choi, Sejin (2020). Perspective. A Hidden Key to COVID-19 Management in Korea: Public Health Doctors. Journal of Preventive Medicine and Public Health. Vol. 53, Pp. 175-177.

Chathukulam, Jos (2020). The Kerala Model in the time of COVID19: rethinking State, Society and Democracy. World Development. doi: https://doi.org/10.1016/j.worlddev.2020.105207

Das, Gouranga G. (2020a).   ‘COVIDonomics’ of combating pandemic. The Korea Times. https://www.koreatimes.co.kr/www/opinion/2020/03/197_287071.html

Das, Gouranga G. (2020b). Fighting the pandemic: Disease, de-globalisation and digital optimism. The Business Standard. https://tbsnews.net/thoughts/fighting-pandemic-disease-de-globalisation-and-digital-optimism-124381

Das, Gouranga G. (2020c). Eradicating Religious Bigotry Could Be First Step In India’s Fight Against COVID-19. The Outlook. https://www.outlookindia.com/website/story/opinion-eradicating-religious-bigotry-could-be-first-step-in-indias-fight-against-COVID-19/351003

Economist (May 30, 2020). COVID-19 and Face Masks: We interrupt this transmission. Pp. 67-68

Economist (September 12, 2020). Free Exchange: Which market model is best? Page. 66.

Government of the Republic of Korea [GROK] (May 2020). Flattening the curve on COVID-19. How Korea responded to a pandemic using ICT.

Huang, Yusheng, Meicen Sun, and Yuze (April 15, 2020). How Digital Contact Tracing Slowed COVID-19 in East Asia. Harvard Business Review. https://hbr.org/2020/04/how-digital-contact-tracing-slowed-COVID-19-in-east-asia

Jeong, Andrew (June 4, 2020). South Korea’s Coronavirus Formula: Heavy on Stimulus, Light on Lockdowns. Wall Street Journal.

Kim, Young-Joo, M. H. Seo, and Hyun-E Yeom (2020). Estimating a breakpoint in the pattern of spread of COVID-19 in South Korea. International Journal of Infectious Diseases. Vol. 97, Pp. 360-364.

Korea Development Institute October 10, 2020. Major Indicators of the Korean Economy. 경제동향 주요지표.Monthly Economic Trends.

Lee, Daejoong. K. Heo, and Yongseok Seo (2020). COVID-19 in South Korea: Lessons for developing countries. Letters on Urgent Issues. World Development. Vol. 135,

Merow, Cory, and Mark C. Urban (October 13, 2020). Seasonality and uncertainty in global COVID-19 growth rates. PNAS. https://doi.org/10.1073/pnas.2008590117  

Park, S., Choi, G., & Ko, H. (2020). Information technology-based tracing strategy in response to COVID-19 in South Korea-privacy controversies, American Medical Association, April 23, 2020. https://jamanetwork.com/journals/jama/fullarticle/2765252

Sakellaropoulou, Roza (2020). Research in the time of a pandemic: Korea’s COVID-19 success story. Springer Nature.

Seegene. (2020). CNN spotlighted ‘‘How this south Korean company created coronavirus test kits in three weeks.’ Seegene, Mar 12, 2020. http://www.seegene.com/press_release/how_this_south_korean_company_created_coronavirus_test_kits_in_three_weeks_2020

Shin, Jinwook, S. Kim, and K. Koh (August 2020). Economic Impact of Targeted Government Responses to COVID-19: Evidence from the First Large-scale Cluster in Seoul. IZA DP no. 13575. Pp 1-27.

Sisaweek. (2020). The story of the rapid development of the ’coronavirus diagnostic kit’ in Korea. Sisaweek, March 25, 2020. (In Korean) https://www.sisaweek.com/news/articleView.html?idxno=132319

Song Soo-Youn.  KAIST develops contact tracing system without privacy breach. Published 2020.06.10

UN News. (2020). First person: South Korea’s COVID-19 success story. UN News Global perspective, May 1, 2020. https://news.un.org/en/story/2020/05/1063112

Wan Kin-Man, Lawrence Ka-Ki Ho, N. W. M. Wong, and Andy Chiu (2020). Fighting COVID-19 in Hong Kong: The effects of community and social mobilization. World Development. Vol. 134. Pp. 1-7.

Won-Chol O (2009). The Korea Story: President Park Jung-Hee’s Leadership and the Korean Industrial Revolution. Wisdom Tree Publications.

World Bank (2020). COVID-19 Coronavirus Response. Protecting People and Economies: Integrated Policy Responses to COVID-19. World Bank, Washington DC, USA.